Furosemide Absorption Altered in Decompensated Congestive Heart Failure

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Abstract
Whether patients with decompensated congestive heart failure had altered absorption of oral furosemide [producing diuresis]. Pharmacokinetic and pharmacodynamic responses were studied in 11 patients receiving their usual oral dose of furosemide while decompensated, and after attaining normal weight. Seven patients also received 25 g of oral D-xylose to further assess intestinal absorption. A 57% decrease in lag time (P = 0.033), a 27% decrease in time to peak serum concentration (P = 0.041), and a 29% increase in the peak serum furosemide concentration (P = 0.008) were seen in compensated as compared to decompensated patients. No significant change was seen in absorption or elimination half-lives, area under the serum concentration vs. time curves for furosemide or in absorption of D-xylose. Although the pharmacodynamics of furosemide were reduced compared to normal subjects, there was little difference in the compensated and decompensated states. An alteration in furosemide absorption in decompensated congestive heart failure is shown.

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